Play therapy is a form of psychotherapy that uses play to help children ages 3-12 express and process their experiences and feelings. It allows children to communicate nonverbally through play, their natural form of expression. Play therapy for pediatric cancer patients aims to reduce stress, release tension, and encourage positive development. It involves various types of play like role play, fantasy play, arts and crafts, and activities centered around medical themes and experiences. The goal is for children to develop self-confidence and coping skills to deal with their illness and hospitalization. Play therapists use toys, games and a safe environment to help children communicate freely without pressure.
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Play therapy for cancer children
1. PLAY THERAPY
CHILDREN WITH CANCER
Presented by
RENITHA NAVIS M
ASSISTANT PROFESSOR
DEPARTMENT OF PEDIATRIC NURSING
SHANMUGA COLLEGE OF NURSING
SALEM
2. What is Play Therapy?
“Play therapy is defined as a dynamic interpersonal
relationships between a child (or person of any age) and a
therapist trained in play therapy procedures who provides
selected play therapy materials and facilitates the development
of a safe relationship for the child (or person of any age) to
fully express and explore self (feelings, thoughts, experiences,
and behaviors) through play, the child’s natural medium of
communication, for optimal growth and development”
(Landreth, 2002)
3. History And Its Meaning
It is a form of psychotherapy since 1990. Play therapy is generally
employed with children aged 3 through it and provide a way for
them to express their experiences and feeling through a natural,
self guided, self-healing process. As children’s experiences and
knowledge are often communicated through important vehicle of
them to know and accept themselves and others.
4. Purpose of play therapy
Develop a more positive self concept
Assume greater responsibility
Become more self accepting, self directing and self reliant
Become more trusting of self
Experience a feeling of control
Become sensitive to process of coping
Develop a internal source of evaluation
Engage in self determined decision making
5. Importance of play therapy for pediatric
cancer patients
Playing is a natural way of building skills, confidence and
personality in a child as well as a way to instill social relations and
proper behavior.
Children who are ill, particularly children with cancer, tend to lose
interest in playing due to their long-term stay at the hospital and
isolation procedures.
Illness and hospitalization can be a major source of stress for young
children. They meet many strangers and have to undergo many tests
and procedures. This affects them deeply and could cause possible
depression .
7. UNOCCUPIED PLAY
Child Is Completely Free To Think, Move And
Imagine.
The Child Is Not Playing Or Watching Anyone Or
Anything In Particular.
They Might Stand Or Sit And Just Do Nothing
8. SOLITARY PLAY
(Independent play)
Children will play with toys by themselves, independently.
Not influenced by others
Does not tent to approach others
Solitary play helps a child to be a thinker
9. ONLOOKER PLAY
The child watches others play but does not
become engaged in their play.
May sit or stand near the children playing
Different from un occupied play as in this play
the child is interested in other children activity.
They might look or talk to the players but not
involved.
10. PARALLEL PLAY
The child plays with toys that are shared
with others.
The child plays beside other children but
communication might be limited or none at
all.
The child mimics others children play but
doesn't actively engage others.
11. ASSOCIATIVE PLAY
The child plays with other children.
The play is not coordinated. They may talk
and share toys but they are still independent
players.
A child plays side–by-side with others,
engaging at times but not coordinating
efforts.
12. COOPERATIVE PLAY
Children Come Together And Play
A Group Of Children With A
Common Goal Or Similar Interests,
Acting Out Adult Situation Or Playing
Formal Games.
13. IS THESE PLAY CAN BE APPLICABLE
FOR PEDIATRIC CANCER CHILDREN
14. WHAT IS MEDICAL PLAY
IT IS A TYPE OF PLAY WHICH
CONCENTRATES ON EVENTS IN
HEALTH CARE SETTING SUCH AS
INJECTIONS, PROCEDURES,
TREATMENTS AND THEIR ILLNESS.
15. PLAY IN ILLNESS
Therapeutic play
It is the use of play
specially on a language for
sick children to
communicate their thoughts
and feeling.
16. CHARACTERISTICS OF MEDICAL
PLAY
Part of its content medically themed and/ or it includes the use
of medical equipment.
Play may be offered or initiated by an adult/ parent, but its
voluntarily maintained by the child.
Medical play is usually enjoyable for the child and is
accompanied by laughter and relaxation. However, the process
of play can be intense and aggressive.
Medical play and preparation are not the same. They are not
interchangeable. When an adult attempts to prepare a child for
a medical event by demonstrating a procedure or familiarizing
a child with equipment, education may occur, but not
necessarily play.
Play may follow familiarization if play opportunities re made
available.
17. PURPOSE OF MEDICAL PLAY
Provide diversion and bring interaction
Help to feel more secure in strong
environment
Lessen stress of sick child
Release of tension and expression of feeling
Encourage interaction and development of
positive attitude
An expressive outlet for creative ideas
Means for accomplishing therapeutic goal
Provide the child on active role.
18. Problems of cancer children
INTERNALIZING PROBLEMS
Feelings of loss of control
Hopelessness
Depression
Anxiety
Frustrations
19. EXTERNALIZING PROBLEMS
Withdrawal
Aggression
Non-compliance
OTHER COMMON DIFFICULTIES
Poor self-esteem
Poor self-image
Changing sense of identity, more
negative
Decreasing social competence
Learning problems
21. ROLE REHERSAL/ ROLE REVERSAL PLAY
This is the most traditional medical play. Children takes
on the roles of health care professionals, acting out
medical procedures and events on dolls, puppets,
stuffed animals or other people ( children or adults).
Real medical material and equipment is used , as well
as specially made toys created for medical play, such as
toy doctor kits, a patient puppet, a doll sized MRI or
hospital bed.
Children often use these type of medical play to re-
enact events they have experienced.
22. MEDICAL FANTASY PLAY
This also involve role playing medical themes. However,
traditional play materials, blocks, doll houses, cars, trucks
and stuffed animals are used to create roles and stories for
medical play, instead of actual medical equipment.
In medical fantasy play, children avoid contact with
feared objects, but can still play out topic for concern.
23. INDIRECT MEDICAL PLAY
Hospital themed activities such as puzzles, games and
songs enable familiarization, exploration and education
related to medical experiences.
This type of play also uses medical materials in non-
traditional ways, such as using syringes to squirt water,
and using IV tubing as drinking straws.
24. MEDICAL ARTS PLAY
This offers many different ways for a child to express
themselves, their understanding of and reaction to their
medical experience. Art activities can vary greatly, including
painting, drawing, collage and 3D sculptures.
Basic art materials are appropriate. Paint, paper, markers and
glue offer a wide range of choices. Including some medical
materials, such as band aids, plasters, gauze and tongue
depressors can enhance the medical theme.
25. How is Play Therapy Administered?
The child is the one who leads the session, so the format in
this sense is free and there is no pressure put on the child to
talk about their difficulties. The trained therapist will use
specific techniques in order to assess how the child reacts to
the world, events and the people who inhabit their world.
Gently the therapist will lead the child to help them gain an
awareness of their feelings and allow them to express their
feelings safely.
26. Points to remember
It is primarily non verbal approach
Age range of mostly children are 2 to 12. but it vary
according to the cognitive and development delay may
participate in play therapy at an older chronological
age.
Time session 30 to 50 minutes but it vary
Mild issue may improve in 6 to 12 session, complex
issue like cancer may require up to 40to 80 sessions.
27. How to use play therapy
To take the patient's mind off treatment
To identify any developmental issues
To encourage children to express
themselves
28. Basic principles of play therapist
Must develop a warm and friendly relationship with the child
Accepts the child as she or he is
Establish a feeling of permissiveness in the relationship
Maintain a deep respect for the child ability to solve his/her
problems and gives the opportunity to do so.
Does not attempt to direct the child’s actions or conversations
in any manner.
Does not hurry the therapy along.
Only establish those limitations necessary to anchor the
therapy to the world of reality and to make the child aware of
his/her responsibility in the relationship.
The therapist recognizes then reflects the child feelings.
29. Procedure of play therapy
THE PLAY ROOM
The Necessary elements within the play rooms are;
The child, The therapist, and the play therapy contents.
The play therapy space is usually a designated room,
set up in a particular and predictable way.
Within the room, there are a wide range of expressive
tools and toys,
Toys including craft materials, dress ups and masks,
musical instruments, puppets, toy animals, toy
weapons, medical equipment, doll houses and
balloons.
Therapy room as needing to contain something to
represent everything in the child’s world.
The range of toys allow a child to understand that a
range of behaviors are permitted in the playroom.
30. Play therapy activities for cancer
children
Share messy moments( babies to 12 year old)
Trade something personal or special ( babies to 12
year old)
Flying feeling balloons( 18 months to 6 year old)
Reading books( 2 to 12 year old)
Popping cancer bubbles( 3 to 12 year old)
Hugging hand activity ( 6 years old and up)
Plan a party( 3 to 16 years old)
Make friendship bracelets( 4 to 12 years old)
Play doctor( 6 to 12 years old)
Write thank you card( 4 to 12 years)
